Clinical Implications of Air Embolism in Patients with CPA Tumor Operated on in Sitting (or Semisitting) Position

Background: The sitting position in CPA surgery enables spontaneous outflow of blood and cerebrospinal fluid from the operation site. This limits the need for an aspirating nozzle and other instruments, which are dangerous for local delicate structures like the facial nerve or labyrinthine artery. The disadvantage of the upright position is risk of pneumatocele and air embolism.

Methods: At the Department of Neurosurgery of the Medical University of Silesia in Katowice, 214 patients who underwent surgery were analyzed. Air embolism was correlated with such parameters as: death rate, duration of hospitalization at neurosurgical and intensive care wards, respiratory or circulatory insufficiency, necessity of respirator usage, and the number of specialists' consultations.

Results: Air embolism did not increase death rate or duration of hospitalization in our neurosurgical ward, but it did expose patients to respiratory failure (P = 0.014). Air embolism is also correlated with hospitalization in the intensive care ward (P = 0.002) and with an increase in the number of specialists' consultations (P = 0.042).

Conclusions: Air embolisms do not increase mortality or duration of hospitalization. We believe that early treatment when air embolisms did occur prevented further complications.